Chapotraphouse

if therapy was rigorous we wouldn't have to suffer through dozens of wrong therapists.

If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg? You should be able to recognize why this would be an unhealthy and unhelpful framing device.

I just don’t agree that these are good analogies.

If you have an accountant, is that a person you pay to pretend to give a shit about your taxes? Is an orthopedic surgeon someone you paid to pretend to give a shit about your broken leg?

Yes and yes. I'm hiring them because they perform a service in exchange for money. It's not reasonable to expect them to care on an individual level about my taxes or my broken leg, I just need them to do their job.

What are your outcome measures for therapy, personally?

One big issue with therapy is that it's difficult to afford unless you have a good job or are on a state-sponsored health plan. The people who are in that welfare cliff are arguably some of the people who need it the most.

And then, once you get it, it's often restricted to "you will have twelve 45-minute sessions to address the issue". It really cannot function properly in a transactional, capitalist model. To really have an impact, it needs to tie in with the pace of life, and if this doesn't take the form of a figure who's present outside the office/clinic, it's prohibitively costly and/or slow to try to link the professional up with the on-the-ground reality.

What we now have access to is something that's on-demand, 24/7, for better or for worse. The provider/client model canmot match this.

There are already so many stories of people spiralling because they started building rapport with an LLM and it's hard to imagine a setting where that is more likely to occur than when you use one as your therapist

There are multiple cases where an LLM is alleged to have contributed to someone's suicide, from supporting sentiments of the afterlife being better to giving practical advice.